


Traumatized

by lightning and a lightning bug (spoons)



Category: Supernatural
Genre: Angst, Coda, Episode Tag, Episode s04e19, References to Suicide, Suicidal Thoughts
Language: English
Status: Completed
Published: 2012-07-07
Updated: 2012-07-07
Packaged: 2017-11-09 09:26:40
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 4,317
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/453934
Author URL: https://archiveofourown.org/users/spoons/pseuds/lightning%20and%20a%20lightning%20bug
Summary: <blockquote class="userstuff">
              <p>Dean takes Sam to the hospital after the events of the episode, and all the doctors assume Sam has tried to commit suicide.</p>
            </blockquote>





	Traumatized

**Author's Note:**

> Coda to 4x19

There’s ghoul brains on his face and his brother’s blood on his hands, and Dean really, really just wants to find some duct tape.

Or anything sticky, or remotely capable of securing the rags to Sam’s gigantic forearms which currently look like he shoved them under a circular saw a couple of times. 

“How’re you doing, Sammy?” Dean asks as he rifles through the drawers in Adam’s dining room. Cloth napkins, candlestick holders, notecards. Jesus, don’t these people keep anything useful in their house? Sam doesn’t answer and Dean whirls around. “Sam!”

“Can we go?” Sam’s eyes are sliding in and out of focus and he’s paler than the corpses Dean just finished exhuming, but he looks all set to jump off the table and make a run for the exit. “Let’s go, Dean. Someone’s probably called the cops.”

“Hang on, hang on.” Dean grabs him by the shoulders, then moves his hands down to Sam’s arms. Fuck, the bandages are completely soaked through, and Sam’s right, the cops are probably on their way. It tends to happen whenever they fire a shotgun in a residential area, which is great for the public law enforcement system and all but for them it’s just fucking annoying.

“There’s a first aid kit in the trunk,” Sam slurs, sounding like he just drank down an entire bottle of Jack’s which Dean has actually seen him do more than once recently. His head lolls on his shoulder, unnatural and terrifying. “I can walk to the car. You drive. I’ll bandage.”

“Your own slit wrists? How’re you gonna manage that, Einstein?” The sight of the bowls of the floor, filled almost to the brim with Sam’s blood, are making Dean sick. He really wants to get Sam patched up _now,_ mostly because he doubts Sam’s ability to walk three steps let alone to the car, but also a little bit because blood is a bitch to get out of the upholstery and he just cleaned the Impala last week.

“I’ll manage,” Sam says firmly, almost petulantly, then before Dean can stop him he’s swinging his legs off the table and letting the rest of his body follow. One lurching step later and it’s all Dean can to do to stop Sam’s head from hitting the floor as he crumples like marionette doll with its string cut.

“Jesus, Sam!” Dean’s panicking now, he realizes that, but it gives him the strength to haul the ginormous body of his unconscious brother up from the floor and throw it over his shoulder. It feels like it takes years for him to reach the Impala, but once he’s there he can barely remember making the journey. He dumps Sam in the backseat, upholstery be damned, then dives in the trunk for the first aid kit. 

As he’s wrapping gauze around Sam’s arms— goddamnit these ghouls really did a number on him, the cuts are viciously deep and there’s two on each arm, diagonal enough to make closing them nearly impossible— he hears sirens in the distance. He goes even faster, leaving his shotgun and the open first aid kit on the floor near Sam’s head, then getting in the drivers seat and tearing off as fast as his baby will allow.

He can’t fix these cuts. His hands are shaking too badly, they’re too deep, and Sam’s lost too much blood. He needs to go to a hospital, which is going to be the cherry on top of this fan-fucking-tastic day.

“Think we’ll maybe meet a hot nurse and knock her up like Dad?” Dean asks the rearview mirror, because if he doesn’t say something right now he’s going to start screaming and that wouldn’t help anyone. Sam just lies there, head rolling slightly as the car tears around a corner.

Dean slams his foot to the floor. He’s already seen one brother’s dead body today. He’s not seeing another.

\---

Tires screeching. Sam’s heavy weight, blood all over his shirt. The bright lights of the ER. Dean shouting until someone listens, and maybe a little bit after that. Sam wheeled away, nurses buzzing around him like flies. He’s almost too long for the gurney, and there’s blood all over his shirt. Dean is told to wait. They talk about transfusions and IVs and Dean is told to wait.

“I always do,” Dean tells them, confused and frantic and hating the cold swinging doors that swallowed Sam up and haven’t given him back. “I’ve been waiting for him for his whole goddamn life.”

They stick him with a pretty nurse that takes him to a waiting room and brings him a cup of water. Dean doesn’t drink it because he’s still seeing Sam’s blood filling those bowls. He puts his head in his hands and doesn’t think about a younger brother kept safe from hunting and killed by monsters just the same. He doesn’t think about a younger brother embracing hunting and getting closer to the monsters every day. He doesn’t think about a Dad who spent his own countless amount of time in waiting rooms like this, raising Hell until he knew his sons were safe.

Instead of thinking, Dean waits. It’s only a matter of time.

“Mr. Hammett?” The doctor is a woman, probably in her late forties, with a kind eyes and laughter lines around her mouth. She looks like the kind of person who actually cares, and Dean feels immediately sorry for her. “Can I ask you some questions about your brother?”

It’s obvious she’s going to ask whether Dean gives her permission or not, since it’s her job and all, so he gestures wearily to the hard plastic chair beside him.

“Would you like to get cleaned up first?” the doctor asks, even as she takes the seat. There’s a lot of pity in those kind eyes, and Dean knows he must look fucking terrible. Sam’s blood is all over his hands and his shirt, and there’s maybe still a little bit of ghoul stuck to him as well. He shrugs, declining her offer. There’s so much more gore in his memories and his mind it feels kind of right to show on the outside for once. Besides, Sam lost so much blood it seems wasteful to wash away this little bit Dean is able to save for him, at least until he’s sure Sam doesn’t need it anymore.

“I’m Doctor Clark,” the woman introduces herself. Her handshake is brusque and firm. Dean remembers his dad teaching him how to shake hands, telling him you can learn a lot about someone from their handshake. “Your brother is currently in the ICU. His wounds are being treated, and he’s receiving a transfusion.”

“I’ll donate,” Dean says instantly. “Whatever he needs— more, I’ll be happy to.” Sammy used to donate all the time. Every six month while he was at Stanford, he told Dean once. Plasma too. It was a good way to make money, an honest way, and it helped people. Their lives had been saved by it more than once, that’s for sure.

“Thank you,” Dr. Clark says, “Well certainly take you up on that offer, though perhaps when you’re a little less… traumatized.”

“I’m not traumatized,” Dean answers automatically, which is stupid, because of course he is, though not for reasons Dr. Clark would ever understand. _I just found out my Dad had another son and he treated him better than me or Sammy, and oh yeah, that kid was murdered by ghouls that then tried to_ eat _Sam and now he’s in the ICU, and did I mention I recently spent forty years in Hell and I have roughly an angel a week telling me I’m supposed to fill some all important cosmic destiny?_ “Sammy’s the one who… I mean—”

He realizes he’s says exactly the wrong thing when Dr. Clark’s eyes fill with even more pity and she says, “Ah yes, Sam.”

“He’s not…” Dean thinks about saying “crazy” but for some reason he stops himself. The look Sam gave him when Dean told him he knew about Alastair's death swims to the front of his mind, but he pushes it away. “He didn’t— it was an accident.”

“Of course. That’s often what people say in these kinds of cases, Dean, but I think we both know that’s not true.” Dr. Clark smiles softly, and really, Dean doesn’t want to be dick to her, but it’s going to be hard because there’s no way he can say _look, my brother didn’t slit his wrists, a ghoul did it for him,_ but he also can’t sit there and act like Sam is some suicide case either.

“My brother wasn’t trying to kill himself,” he tells the doctor, point-blank, which again turns out to do the exact opposite of derailing this particular conversation.

“That may be true. These types of acts are often a person’s way of crying for help rather than a serious attempt to end their lives. Can you tell me anything about Sam’s state of mind, or his other injuries?”

“Other injuries?” The bottom drops out of Dean’s stomach. Had the ghouls done something else to Sammy that he didn’t notice?

Dr. Clark checks her chart. “A bruise on the left cheekbone, a deep puncture on the left side, and an Ace bandage around the right ankle, in addition to the five cuts on his forearms.” She returns her gaze to Dean, and it’s gone from kind to shrewd and almost piercing. “Can you tell me how he got those?”

Dean doesn’t answer. The ankle he remembers was from the ghoul trying to pull Sam under the car. The bruise and the puncture must have happened when they had Sam tied up. Anger surges up in Dean’s throat; he feels like he’s swallowing his own tongue.

Dr. Clark leans closer. “Dean, how is your relationship with Sam? Would you say you two are close?”

 _I practically raised him,_ Dean wants to say. _We’ve lived on top of each other almost our whole lives._ He opens his mouth, but he tongue is still caught. _He’s changed since I went to Hell._ He almost gags, and his eyes start watering. _He’s keeping secrets from me, and I think they’re bad. Really bad._ He has to say something, just so Dr. Clack will stop freaken staring at him. _I’m used to being so scared for him it makes me sick, but being scared_ of _him is something new._

“Yeah,” Dean croaks. “We’re pretty close.”

“Any other families members?”

_Just our murdered mother, and our Dad who sold his soul and got to take a tour of Hell for half a century. Oh, and the brother we didn’t know we had whose body we’re going to go salt and burn as soon as we’re done here._

“No, no other family members.”

“Significant others?”

_One murdered almost-fiance, a werewolf we put a bullet into, and now a demon who I’m pretty sure would like nothing more than to redecorate her apartment with our body parts. As for me, there’s a long line of fucks with no chance or time for anything more. The latest one was an angel._

“No, it’s just me and Sam.”

Dr. Clark nods like Dean’s just told her his entire life story with that sentence. And in a way, Dean supposes, he kinda has.

“This isn’t the first time Sam’s hurt himself, is it, Dean?”

It’s a good thing Dr. Clark is nice and as bullshit free as it seems possible for a doctor to be, because if it were anyone else asking these questions, Dean would probably have laid them out on the floor with a single punch by now. As it is, he just feels like running away, straight into the ICU so he can grab Sam and get them both in the Impala and speeding right out of this stupid town. When he glances at the doors over his shoulder, Dr. Clark must sense some of his intent because she leans forward and puts a hand on his knee.

“Dean, it’s not your fault, okay? What Sam did… you couldn’t have stopped it.”

Dean almost laughs out loud at that one, because of course he could have stopped it, if he’d realized what was going on a little sooner he could have put his shotgun to the ghoul’s head and blown it away and they could have left without Sam ever having to bleed out in the backseat, and Dean would never have been counseled by some well-meaning but utterly misguided doctor.

“And it doesn’t have to be this way. Sam can get help.”

Dean does laugh then, but for some reason it comes out sounding closer to a sob. “Don’t you think I’ve tried?” he finds himself saying. “He’s been so different since I came back, and yeah, I’ve been going through some stuff of my own, but I don’t want him to— and he _knows_ it’s wrong!”

“Dean, these things are not about right and wrong. It’s about Sam, and what he’s feeling, and how he’s coping with those feelings. Or perhaps, not coping. You said he’s been different since you got back? Got back from where?”

“From down south… America. South America.” Dean pulls himself away from Dr. Clark’s gaze, her kind eyes suddenly far too much to handle. It’s been a long time since anyone looked at him like that. “For a business deal.”

“How long were you gone?”

“Forty— uh, four months.” Dean swallows, shuddering through the surge of memories mentions of Hell always bring. “Sam didn’t… take it well.”

“And now that you’re back together, things are different? Sam is different?”

“He won’t listen to me, and he’s gotten himself into some serious shit, and he thinks it’s okay but it’s so _not_.” Dean realizes he’s rocking slightly, leaning into the gentle warmth of Dr. Clark’s sympathy then pulling away from it. “He can’t see what this is doing to him, what he’s becoming, and I just—” Dean’s voice breaks and Dr. Clark’s hand on his leg squeezes encouragingly. He tries to stop the tide of words but before he can help it he’s stuttering out, “I’ve always taken care of him, you know? From the second he was born, I’ve watched out for him, and yeah, I messed up when I left, and now that I’m back I’m not exactly— but he’s just gone so far this time I don’t know if I can pull him back. And with everything else going on, it’s like… it’s like I’ve forgotten how to try.”

“Dean, I know you want to look after your brother,” Dr. Clark says quietly. “But he’s going to make his own mistakes. And hopefully, he will learn from them. There are trained professionals who can help him with that process. It’s not your job to protect him from everything.”

“It is, though, it _is_.” Dean’s voice is shot now and his eyes are stinging, but he’s not crying here, sitting in the waiting room talking to some doctor who’s never seen a monster and, if there’s any sort of justice in the world which Dean should know by now there’s not, never will. He shifts his leg, dislodging her hand, and resolutely refuses to look her in the eye anymore. “Can I see my brother?” he asks.

There’s a long pause, like Dr. Clark is going to refuse his request, or she’s thinking of another way to continue their conversation, but then she stands up and says gently, “I’ll see what I can do.”

As soon as she walks away, Dean puts his head back in his hands. He thinks about Adam, before they knew he was a fucking ghoul. Sam was so ready to get him into hunting, parroting John Winchester’s words to him, the same words that had driven Sam out of Dean’s life for nearly four years. If Dean needed any proof that Sam was different now, that was it. He had spent one day with Adam and been ready to rip him away from school, family, friends, a normal life, all those things Sam had fought tooth and nail for when he was younger.

Dean had spent a day with Adam and thought _great, another little brother for me to fail._

“Mr. Hammett?” It’s the pretty nurse from before. She looks nervous, and Dean remembers he’s still covered in blood. It’s dried and crusted now, making his shirt stiff and his face feel like he’s wearing a mask. Too bad a wild-eyed and blood-soaked Dean Winchester is much less of a lie than the cleaned up, crazy-on-the-inside version that’s usually walking around. “You may see your brother now, if you’d like.”

She leads him to a small room at the end of the hallway. It’s a single, and the nurse lets him go in alone. _Just me and Sam._ He hesitates in the doorway, seeing again in his mind Sam strapped to that table, blood running down his arms, head dropping back like it was too heavy to hold up, panic in his voice when he called Dean’s name.

The sight of Sam laying in a hospital bed, hooked up to an IV with bandages up to his elbows isn’t much better, but Dean puts on his best game face because Sammy looks pale and upset and very, very young.

“So, Sammy, they read you the riot act yet? Try to figure out why you wanted to end it and leave this cruel, cruel world?” It’s meant as a joke, but with the monitors blinking and beeping in time and the skin of Sam’s eyelids looking practically transparent, it falls a little flat.

Sam still makes an attempt at a smile and an eye roll. “Yeah, they wanted to know if I had any traumatic experiences in my past.”

He snorts, but given the room they’re in and they day they’ve had, that also feels a little too heavy. Dean shifts awkwardly, reaching out a hand to check the tightness of Sam’s bandage before he realizes what he’s doing. “They gonna let you out?” he asks gruffly.

“If there’s someone “competent and capable” to take me home and make sure I don’t try it again.” Sam’s still trying to keep it light, but he hasn’t raised his head from the pillow yet and his voice is very small. He doesn’t comment on the way Dean is still touching his bandages, tracing the criss-crossing lines. “Or I can stay here for a seventy-two-hour evaluation period.”

“That where they talk about your feelings and try to convince you the world is all sunshine and rainbows?”

“Pretty much.”

“Huh.” Dean’s checking the IV now, letting the tube of fluid slide across his fingers until they reach the bag. “If you wanted… we could stick around for that.”

“For what?” Sam makes the effort to raise his head now, but he doesn’t get it too far before slumping back against his pillows with a little groan that makes Dean’s hands start to shake. “For me to be psychiatrically evaluated? Some how I don’t think “apocalypse” is one of their diagnoses.”

“Well I don’t know.” There’s nothing left for Dean to examine now except Sam himself and he really doesn’t want to look too closely at Sam right now because then he’ll see just how weak and hurt Sam actually is, and realize how close he came to losing him. “Sitting around, talking about your feelings, singing Kum Bi Ya with a bunch of emo kids… that’s kind of your thing, right?”

“Dean.” Sam shoots him a look that could be fond exasperation or else utter disdain. It’s difficult to tell when his eyes are only half open. “I seriously doubt there’s anyone here who could understand even a fraction of what I’m going through.”

“Right.” Dean feels a cold weight settle in his chest, pretty sure Sam was including him in that last statement. “But if you did want—”

“Dean, please.” Sam makes a pained sound, and Dean tosses aside his resolution not to look at him in favor of anxiously scanning every inch of Sam’s face, trying to figure out what’s wrong. Sam’s eyebrows are all scrunched together, and his lips are tight. It’s the face he used to make when Dean was pulling a needle and thread through his skin, or right after he’d had a vision. He’s also panting slightly, which is not fucking normal and sends Dean into a mild panic.

“Sammy? Talk to me, buddy. What— is it the pain?”

“I just want to go home,” Sam says, small and vulnerable in a way he hasn’t been for a long, long time. He sucks in a breath and tilts his head back, eyes slamming shut and tendons in his neck straining. Dean puts a hand on his shoulder, totally unsure what to do and hating it. After a moment the tension passes through Sam and he slumps back, looking, if possible, even more worn out than before. His eyes are over-bright when he fixes them on Dean. “Please, Dean. Let’s just go.”

“Sure, Sammy.” Dean isn’t going to say no to Sam when he looks that, but he is sure as hell is talking to another doctor before they leave. This is not a normal reaction to a transfusion, and Dean’s head is filling with all sorts of possibilities of what could be going wrong.

His agreement seems to have appeased Sam, however, because he sort of smiles around suddenly chatting teeth, then promptly loses consciousness again, and yeah, Dean needs a doctor right the fuck _now._

He’s banished to the waiting room again, but it’s not too long before they send someone after him and announce Sam is awake again, and asking for him. Dean hurries back to the room, wondering distractedly how many times he’s going to have to walk this hallway, and finds Sam wide-eyed and frantic. 

“Dean!” Sam says, and seizes his arm as soon as Dean gets close enough. “Dean, I don’t want it, okay? I don’t need it, I don’t want it, I don’t. I mean it.”

“Okay, Sammy.” Dean pats his hand, half trying to comfort him and half trying to encourage him to loosen his death grip. Dean swears he can hear the leather of his jacket cracking. He shoots bewildered eyes to the doctor in the room, who also looks a little confused, which is not terribly encouraging. “What is wrong with him?” Dean demands.

“His body is having a… unique reaction to the transfusion,” the doctor explains, shifting his attention from Sam to Dean and carefully smoothing his face into more neutral expression. _Too late, pal,_ Dean thinks. “It’s almost as if his body is rejecting the blood, though it isn’t. It’s his correct blood type and there should be no reason for these difficulties. And it’s not his immune system that’s acting up it’s… something else.”

“Something like what?” Dean realizes he’s being a bit of a dick, but his arm is still being crushed by Sam’s giant paw while Sam mutters rapidly under his breath.

“I honestly can’t say.” The doctor makes an apologetic face and it’s all Dean can do not to roll his eyes. “But he is stabilizing quickly. Physically, anyway. The disorientation most likely has to do with the pain medication he was administered, or lingering mental shock from the failure of his suici—”

Dean cuts him off with a growl. “When can I take him home?”

“If he’s still stable in the morning, he may be released. Of course, there’s a procedure—”

“Of course there is.” Dean turns his back on the doctor and sets to work prying Sam’s fingers from his arm. He’s struck by the memory of Sam as a baby, how he would reach through the bars of his crib and grib Dean’s outstretched index finger like he was never going to let go.

Dean sleeps in a chair next to the Sam’s bed for the night. Or, he tries to sleep. He spends most of the time checking Sam’s breathing, talking him down from half-formed nightmares, and just pacing the floor, resolutely trying not to think of what could be so wrong with Sam that would make his body reject a transfusion of normal human blood. For a while he considers calling Castiel and asking the angel to heal Sam like he’s healed Dean before, but he doesn’t. He’s pretty sure Cas would refuse to do it, and Dean doesn’t think he could handle that right now.

In the morning, Sam’s condition has improved enough that the doctor grudgingly signs his release slip. Both he and Dean get the speech again about mental facilities, and where to get help once Sam decides he needs it, and how he doesn’t have to go through it alone. Then Dean gets Sam into a wheelchair and makes a few lazy cracks about it that earn him the finger, and they make their way to the parking lot.

Just before they reach the doors that will take them outside, Dean spots Dr. Clark. She’s watching the two of them with the same warm gaze she used on Dean earlier, but now it’s tinged with a distinct air of sadness. Dean feels kind of bad about that, but he also can’t stop himself from slipping a hand onto Sam’s shoulder, a somewhat defiant gesture as if he’s saying, _Sammy will be fine, because he’s got me._

Dr. Clark’s expression gets even sadder than, and Dean is suddenly unsure who he’s trying to convince, her or himself. He starts pushing Sam’s chair again— the Impala is right outside the doors, he can see it, shining black and strong in the early morning sun— and Dr. Clark gives him a final nod.

 _Take care of him,_ she’s saying.

Dean nods back, giving Sam’s shoulder a squeeze. _I always do._


End file.
